Medullary cystic disease is an important cause of renal failure in ado
lescent patients. Imaging plays a primary role in the diagnosis of thi
s entity as cysts are characteristically seen in the renal medulla and
corticomedullary junction with normal to small sized kidneys, Imaging
studies that do not use intravenous contrast or ionizing radiation ar
e particularly useful given the young age of these patients and presen
ce of renal failure. In this case, we demonstrate the imaging findings
of medullary cystic disease by MRI.